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. 2016 Oct-Dec;5(4):196-203.
doi: 10.4103/2278-330X.195345.

Efficacy and toxicity profile of maintenance pemetrexed in patients with stage IV adenocarcinoma lung in Indian population

Goyal Pankaj  1 , Batra Ullas  1 , Dinesh Chandra Doval  1 , Jain Parveen  1 , Upadhyay Kumar Amitabh  1 , Prasanta Kumar Dash  1 , Jain Akhil  1 , Mohit Agarwal  1 , Bajaj Rajat  1
Affiliations

Efficacy and toxicity profile of maintenance pemetrexed in patients with stage IV adenocarcinoma lung in Indian population

Goyal Pankaj et al. South Asian J Cancer. 2016 Oct-Dec.

Abstract

Context: Lung cancer has been the most common cancer in the world for several decades. Pemetrexed is recommended as an option for the maintenance treatment in metastatic adenocarcinoma lung, if disease has not progressed immediately following platinum-based chemotherapy.

Aims: To study efficacy and toxicity profile of pemetrexed as a maintenance chemotherapeutic agent in patients with stage IV adenocarcinoma lung, not progressing after first line chemotherapy. Settings and Design: This was an observational, prospective. We enrolled patients with stage IV adenocarcinoma lung who has not progressed on first line chemotherapy, from September 2013 to August 2014 at a tertiary care cancer institute in North India.

Materials and methods: In all, 108 patients with stage IV adenocarcinoma lung were started on induction pemetrexed/platinum chemotherapy. 60 patients with no disease progression & ECOG PS 0-2 were started on Pemetrexed maintenance. Progression free survival (PFS) and toxicity profile were recorded.

Results: The mean number of maintenance cycles was 8.3 (range 2-28). 13 (21.6%) patients took >10 maintenance cycles. Pemetrexed maintenance therapy resulted in progression free survival (PFS) of 5.4 months. PFS on pemetrexed was consistent for all patient subgroups, including induction response: complete/partial responders (n-31) and stable disease (n-29). 14 patients had grade III/IV adverse events with anemia being the most common in 3/60 patients (5%). 3 patients (5%) developed renal dysfunction out of which 1 was grade III.

Conclusions: Pemetrexed continuation maintenance chemotherapy is active and well tolerated. Pemetrexed maintenance should be considered in patients with advanced adenocarcinoma lung patients who have not progressed on completion of induction chemotherapy.

Keywords: Adenocacinoma lung; pemetrexed; pemetrexed maintenance.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Selection of patients for study
Figure 2
Figure 2
Proportion of patients with metastasis
Figure 3
Figure 3
Kaplan–Meier plot for progression free survival shows survival probability against progression free survival given as days of maintenance
Figure 4
Figure 4
Kaplan–Meier plot for progression free survival shows survival probability against progression free survival given as days of maintenance in stable disease and partial response/complete response. 1 = Stable disease, 2 = Partial response/complete response
Figure 5
Figure 5
Kaplan–Meier plot for progression free survival shows survival probability against progression free survival given as days of maintenance for males and females (Sex: 1 = Male, 2 = Female)
Figure 6
Figure 6
Kaplan–Meier plot for progression free survival shows survival probability against progression free survival given as days of maintenance for best overall response as stable disease and partial response. Best overall response: 1 = Stable disease, 2 = Partial response/complete response
Figure 7
Figure 7
Kaplan–Meier plot for progression free survival shows survival probability against progression free survival given as days for plaintiff 0/I and PS-2
See this image and copyright information in PMC

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